Rochester, MN, 55905, USA
10 hours ago
Senior Manager- Denials Management Operations
**Why Mayo Clinic** Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans (https://jobs.mayoclinic.org/benefits/) – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. **Benefits Highlights** + Medical: Multiple plan options. + Dental: Delta Dental or reimbursement account for flexible coverage. + Vision: Affordable plan with national network. + Pre-Tax Savings: HSA and FSAs for eligible expenses. + Retirement: Competitive retirement package to secure your future. **Responsibilities** The **Senior Manager – Denials Management Operations** plays a critical leadership role in the execution and performance of day-to-day denial management activities across a large, enterprise health system. This position oversees multiple specialized teams responsible for managing incoming, priority, and resolution-stage denials, ensuring optimal performance in alignment with organizational goals and compliance requirements. The ideal candidate brings strong operational leadership, the ability to manage multi-skilled teams, and a firm grasp of key revenue cycle KPIs. The Senior Manager will also collaborate closely with PRIZM teams to align on denial trends, provide feedback loops, and contribute to data-informed performance improvement. Additionally, this role will be a key point of contact for teams working with external global vendors, ensuring quality, efficiency, and accountability. **Key Responsibilities:** + Direct daily operations of denials management teams including those focused on **new incoming denials** , **priority denials** , and **denial resolution** . + Manage a team of Senior Representatives and Representatives across multiple functions and locations. + Ensure departmental and enterprise KPIs are tracked, met, and continuously improved (e.g., denial overturn rates, days to resolve, appeal success rates). + Partner closely with the PRIZM team to monitor denial trends, identify feedback loops, and guide data-driven improvements. + Provide frontline feedback on denial patterns to upstream departments, including clinical documentation, patient access, and billing teams. + Collaborate with enterprise vendor management teams and global service providers to align on operational execution, productivity, and quality expectations. + Develop team performance metrics, conduct regular reviews, and implement performance improvement strategies where necessary. + Ensure all activities are compliant with payor guidelines, organizational standards, and applicable regulatory requirements. + Act as a coach and mentor to staff, fostering growth and engagement through ongoing development and feedback. + Maintain a strong operational rhythm with cross-functional stakeholders, ensuring escalation pathways are in place and effectively utilized. + Support broader revenue cycle initiatives, participating in committees, task forces, or workgroups as needed. **Qualifications** **Required:** + Bachelor’s degree in Business, Healthcare, Finance, or related field, **and** 10 years of relevant experience including 5 years of leadership experience **OR** 14 years of relevant experience in lieu of a degree, including at least 5 years managing people and operations. + Proven ability to manage high-volume operational teams in a complex healthcare environment. + Deep understanding of denial workflows, appeals, root cause analysis, and operational KPIs. + Demonstrated success managing people, driving performance improvement, and optimizing team structures. + Experience working in or closely with revenue cycle systems, including denial management platforms like PRIZM. + Excellent communication and relationship-building skills across administrative, clinical, and vendor teams. **Preferred:** + Experience managing multi-site or remote teams, including global vendor operations. + Familiarity with EPIC, and other denial and appeal tracking tools. + Prior work in a large academic health system or matrixed health enterprise. + Involvement in denial prevention workgroups, HFMA task forces, or payer-provider collaboration initiatives. **Key Competencies:** + Operational Execution & Prioritization + Team Leadership & Talent Development + Metrics-Driven Accountability + Stakeholder Coordination & Feedback Loop Creation + Vendor Oversight & Partnership Management + Revenue Cycle Process Knowledge + Strong Communication & Situational Awareness **Additional Information:** + This position may require occasional travel based on operational needs or vendor coordination. + Ability to operate in a fast-paced, performance-driven environment with rapidly changing priorities. **Exemption Status** Exempt **Compensation Detail** $138,257.60 - $200,512.00 / year **Benefits Eligible** Yes **Schedule** Full Time **Hours/Pay Period** 80 **Schedule Details** Monday - Friday, 8am - 5pm **Weekend Schedule** n/a **International Assignment** No **Site Description** Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. (https://jobs.mayoclinic.org/alllocations) **Equal Opportunity** All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law" (https://www.eeoc.gov/poster) . Mayo Clinic participates in E-Verify (https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf) and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. **Recruiter** Tavy Smalls **Equal opportunity** As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.
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